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患者,男,63岁。间断性头晕,性功能低下20多年,低血压11.97/6.65kPa(90/50mmHg),近4—5年来病情加重,视力差,视物模糊,记忆力差,睡眠时间延长,说话时就能睡着。曾按脑萎缩治疗,入院前已卧床5个月。于1990年5月24日入院。检查:表情淡漠,记忆力差,动作迟缓,视力:左0.8,右1.2。视野:双颞侧偏盲。眼底:原发性视神经菱缩,左侧肢体肌张力增高,共济差。蝶鞍相示:前后径约17mm,深径14mm,鞍底变薄。头颅CT扫描示:鞍内有1.2×1.1cm大小圆形等密度肿瘤阴影。诊断垂体腺瘤。行经鼻蝶窦入路肿瘤切除术。术中见鞍底变薄,灰红色肿瘤位于隔下,约1.3×1.2cm大小,边界清楚,分块切除瘤体。病理报为:星形细胞瘤。
Patient, male, 63 years old. Intermittent dizziness, sexual dysfunction for more than 20 years, hypotension 11.97 / 6.65kPa (90 / 50mmHg), the past 4-5 years, exacerbations, poor eyesight, blurred vision, poor memory, prolonged sleep, sleep when speaking . Once treated by brain atrophy, bed rest five months before admission. On May 24, 1990 admitted. Check: indifferent expression, poor memory, slow motion, visual acuity: left 0.8, right 1.2. Vision: Double temporal hemianopsia. Fundus: Primary optic neuronal deformity, left limb hypertrophy, a total of poor. Sella phase show: front and back diameter of about 17mm, deep 14mm, thinning of the sella. Head CT scan showed: saddle within the size of 1.2 × 1.1cm circular isograd tumor shadow. Diagnosis of pituitary adenoma. Transnasal sphenoid sinus tumor resection. See intraoperative thin sella, gray-red tumor located in the septum, about 1.3 × 1.2cm size, clear boundary, the block removal of the tumor. Pathology reported as: astrocytoma.